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Fees to be Charged YES NO
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<br /> P{an Review �
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<br /> Inves#igation Fee
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<br /> � Sewer Connection
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<br /> �la�er.-Connec�ion:-� .,. ���..,r;-���1 .,
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<br /> Park Fe�e
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<br /> - Calculated By.:
<br /> S uaee Foota e $ per Square Foota e
<br /> Basement X = �
<br /> 1 St Floor : X _ � <
<br /> 2"d Floor � X i _ � ; �
<br /> Garage X = $
<br /> Estimated.Construction Valne: $ �SO��D� �
<br /> Orono fnspections Required Work Requiring Separate Permits Required State Perrnits
<br /> :❑ Site Plumbing ❑ Grading/�illing ❑ Well
<br /> ❑ Hardcover"Removal IVlechanical ❑ Fire �' Electrical
<br /> fl Footing ❑ Septic � 1Nater:Connection
<br /> ' ❑ :P.oured V1(all - � �ireplace 0 Sewer Connection `
<br /> � Foundation Surve . ,
<br /> Y ❑ Mason,ry �0' Lawn Irrigation -_
<br /> 0 Radon Rock Bed ❑ Mfg.
<br /> Framing � O.thec(specify)
<br /> Insulation
<br /> :❑ s=Built Survey
<br /> �inal
<br /> . .,,
<br /> � Other(specify) -
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<br /> REMARK$ (in-fiouse): �� �— Y'Ul>f � �,�'%i'��LC�.G�� `;�t,c� �=��-LL�- (.�'1 ►�1-2��, � . �.
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<br /> Other Re�iew: ;Reviewed by: Date Approve�:
<br /> Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO
<br /> REM,�►RKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERM(T)
<br /> Updated: 09/11/2009
<br /> z:\forms\ptan review check(ist.docx
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